The cancer vaccine debate

February 06, 2007

For generations, the arrival of a potent new vaccine against a killer disease was a reason to celebrate. In the 1950s, for instance, parents flocked to get their kids vaccinated against polio. School kids now get a range of vaccinations for communicable diseases, from measles to diphtheria. Some parents have balked at the risks. But most believe those risks are far outweighed by the overwhelming benefits of keeping their kids safe from serious illness. That's why the state requires those vaccinations.

But what about Gardasil?

That's the vaccine hailed last year as highly effective against two strains of human papillomavirus (HPV), which are responsible for about 70 percent of cervical cancer cases. The federal Centers for Disease Control and Prevention recommended routine vaccination for girls age 11 and 12. Shots can be started as young as 9; women 13 to 26 also should get vaccinated, the CDC says.

If many parents have welcomed the chance to protect their daughters, some have reacted more guardedly. The vaccine, after all, doesn't prevent a childhood disease, but one that would not strike for many years. Kids are not at risk in the classroom, through casual contact, as with most other diseases calling for mandatory vaccination. HPV is a sexually transmitted virus.

Add to that the high cost--$360 for three doses--some reportedly inadequate insurance reimbursment and all the issues surrounding abstinence and teenage sex, and it's no wonder that many politicians are treading carefully.

Not, however, Texas Gov. Rick Perry. Last week, in a surprising decision, Perry ordered shots for 11- and 12-year-old schoolgirls. Parents can opt out for reasons of religion or conscience, the governor's office said.

There's a similar bill in Springfield to make HPV vaccination mandatory for schoolgirls except when parents object for religious or medical reasons.

Should the shot be mandatory? This would be an easier decision if Gardasil were catching on quickly across America. It wouldn't be necessary to issue a mandate. But so far, Gardasil is not being used as often as some doctors would like, the Associated Press reported. That's probably about cost and insurance coverage and undoubtedly some parents' queasiness over vaccinating a preteen girl against a sexually transmitted disease.

The Gardasil debate forces us to think about a question of principle: Should the state require medical treatments for diseases that aren't easily communicable in our day-to-day casual contact with one another? That's a big step from our current public health policies for protecting children in classrooms and on the playground. Examined through that prism, the Gardasil debate may well be the first of many as drug companies develop new vaccines--or even cures.

Gardasil is a terrific breakthrough in the fight against cancer. On average, there are 9,710 new cases of cervical cancer and 3,700 deaths in the United States each year. Still, it's premature for this vaccine to be added to the mandatory list for Illinois schoolchildren.

We strongly encourage parents to ask their pediatricians about the vaccine. When parents get the facts, it's hard to imagine that most wouldn't want this shot for their kids.